Recently released Defense Department numbers reflect a significant increase in sexually transmitted infections across the services.
Military Health System officials say that rates of some types of STIs, in particular chlamydia, gonorrhea and syphilis, have risen sharply for male and female service members, according to a recent report.
Fort Knox medical officials share DOD's concerns, urging all personnel to get tested and practice safe sex.
"Our average of quarterly cases for [chlamydia, gonorrhea and syphilis] is about 15 without Cadet Summer Training here," said Capt. Shantyl Galloway, lead nurse at Fort Knox Army Public Health Nursing. "With CST here, it goes up to about 20 per quarter."
The Centers for Disease Control and Prevention confirmed surges of the same three types of infections among federal civilian employees as well, posing challenges for more than 1.3 million DOD personnel, 84 percent of whom are men.
"We have a large number of males in the service, and the population we see normally is the 18 to 25 year olds. STI is most common in that age group," said Norma Jean Suarez, a nurse practitioner in preventive medicine at Brook Army Medical Center in San Antonio in a June 26 Military Health System article.
Fort Knox numbers follow roughly the same gender and age trends. From June 2016 to the same month in 2017, the Fort Knox Army Public Health Nursing facility reported 178 confirmed cases of infection. Though that number dropped to 149 the next year then to 88 by this June, Galloway said even one case can create a web of danger -- what Galloway calls a chain of infection.
"The chain of infection and the spread of the disease is a huge concern just because some STDs may not trigger symptoms in people, so Soldiers won't know they have it," said Galloway. "If they don't get tested and they don't get treated but they're still having unprotected sex with people, it's spreading around."
Because of the need to stop the chain of infection, the facility is required to report positive test results to Hardin County officials for tracking, call the infected patient to determine if they have been treated and set up an appointment for what Galloway calls a contact trace interview.
"During that interview, we talk to them about all their sexual partners," said Galloway. "We get a list of names for all their sexual contacts and either have that person call the list and let them know that they need to get tested, or we do it."
Galloway said her biggest concern is making sure the Fort Knox community understands that nurses are there to treat community members and stop the chain of infection from spreading. However, any information they gather remains confidential.
Another concern is making sure Soldiers and others understand the myths surrounding sexually transmitted infections and diseases, including assuming HIV has been eradicated in the military.
"A lot of times with the younger Soldiers, I like to make it a point to talk to them about the fact that there are HIV-positive Soldiers in our ranks across all services," said Galloway. "They think they can have unprotected sex and they're completely safe.
"The same with the other ones -- chlamydia, gonorrhea -- I think there's a misconception that, 'If I get it, I'll just take a pill and cure it, and I'll be fine.' What they don't know is that the more you get exposed to these bacteria, the more they start causing lifelong complications."
She pointed out that gonorrhea is becoming resistant to antibiotics, with only one successful treatment for it.
"When it becomes resistant to the treatment, what's going to happen then?" she asked. "If you can't get rid of a bacterial infection in your body, eventually you're going to get a blood infection. It's these things that they don't understand."
Galloway pointed out another consequence of unprotected sex: "If females get exposed to bacteria such as chlamydia time after time, they can't get what's called pelvic inflammatory disease and have what's called an ectopic pregnancy, or affect them where they can't have children at all."
Another myth surrounds claims of a preventative cure for HPV. Galloway said HPV is a rapidly mutating virus that changes almost as fast as it is spread.
"It keeps morphing," said Galloway. "People with one strain of HPV have sex with people with another strain, so there's hundreds of different strains out there. What the vaccine protects them against is less than 10 strains that can cause cancer. It doesn't protect you necessarily from all the strains of HPV."
Because of so many myths floating around, Galloway urged individuals and organizations to take advantage of what the Fort Knox Army Public Health Nursing facility offers and get some education as well as free condoms.
"Getting tested is very, very important as a preventative measure to stop the spread of something you may already have, but prevention is key," said Galloway. "The safest thing to do is just abstain from sex, but a lot of times that's just not realistic and we know that."
She said it's also important to keep your relationships monogamous, and talk about sex with your partner.
"Review labs together and have that open dialogue," she said. "That may sound crazy but you need to make sure that the person you trust with your life is as healthy as they say they are."
For more information, to get tested or to schedule a class with one of the nurses at the clinic, walk into Building 6289 off of Wilson Road from 7:30 a.m. to 4 p.m. Monday-Friday or call (502) 624-6243.
(Editor's Note: Military Health System Communications Office contributed to this article.)
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